Treatment for NHS cuts

HAVING seen Labour's heavy spending transform the financial landscape of the NHS, the coalition will now have to preside over a similarly significant change in the organisation's culture. Andrew Lansley, the Health Secretary, does not have the spending power of his predecessors so will have to solve the health service's many problems, from an overly-bureaucratic approach to high death rates, on a slimmed-down budget.

If the reduction in NHS management is carried out with surgical precision, then it could free millions of pounds to be used on frontline care. Cutting the number of executive positions will be met with approval in certain parts of the Conservative party, but standards must not be allowed to fall. It is inevitable that if more than 1,000 staff leave this region's primary care trusts and strategic health authorities, and are not replaced, then an even greater burden will be placed on the remaining workers.

They are already under great strain, which goes some way to explaining the vastly varying death rates, identified by the Dr Foster report, at 19 NHS hospital trusts in England.

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These figures, showing patients' chances of survival seem to differ depending on the part of the country in which they live, are a cause for particular concern.

So too is the high number of deaths after surgery at two hospital trusts, including Hull and East Yorkshire Hospitals NHS Trust. Such research undermines public confidence in the work of the medical profession, despite the undoubted dedication of Britain's doctors and nurses.

Patients accept that mistakes cannot be eliminated but a total of 62,800 "adverse medical events" and tens of thousands more avoidable blood clots and accidental lacerations, are deeply worrying. There is something missing, whether it is during the university medical training, the oversight of newly-qualified medics or the checks on experienced professionals, and it is up to Mr Lansley to find out what has gone wrong.

Such concerns, and the urgent need for savings, are a legacy of Labour's piecemeal approach to NHS reform. While waiting times were reduced, the state's health bureaucracy, and particularly the pay of senior hospital staff, rose with little restraint. The coalition has begun the process of diagnosing the problems of the NHS, now it must carry out the treatment.